While I have never been to China, I have had contacts with physicians in China, and the literature on the healthcare system in China is voluminous. And it is an enormous market, in terms of the sheer number of people, the growing wealth, and huge array of health problems it faces. Just today, I read a brief summary of a visit to China by the President and CEO of the Healthcare Financial Management Association. [R. Clarke “China Chronicles” HFMA.org/Views Sep 14, 2007]

In this article, Clarke reported on the cavernous gap between private and public hospitals in urban areas compared to rural facilities. Urban hospitals often have facilities, equipment, staff and capabilities comparable to western countries, and the added dimension of traditional Chinese medicine grafted on. This is easily incorporated into treatments by physicians, and is highly acceptable to patients.

By contrast, rural hospitals can be lacking in virtually everything the urban hospitals enjoy. The staff may be well-trained and attentive to patients’ needs, but the facilities can be old, in desperate need of repair, of even basic cleaning of dirt and mold, and equally desperate need of modern equipment. Opportunities for the U.S. to help are huge, though the threat that upgrading their sickcare system and covering the 70% of the population who are uninsured would bankrupt the country are very real.

We may have a far greater and more meaningful opportunity (as far as China is concerned) if we can export our proactive health management (PHM) technology. And by this, I do not mean the kinds of technologies used in one Medicare disease management demonstration project where the average costs per patient per year were $2640. I mean the kinds of PHM technologies that can be offered at costs of $5-10 per participant per year.

The challenge will be to enable consumers and sponsors in China that are interested in the proactive alternative to sickcare, and its potential to reduce the incidence and prevalence of disease and injury enough to adopt or purchase such technologies. This will mean expanding online access to as many people as possible, though access is at least fairly widespread. The challenge is greatest in rural areas, where fewer people have access to their own or public Internet sources.

It is already the case that the people of China are beginning to suffer from many of the sicknesses caused by excess indulgence, though smoking and alcohol problems have been a problem for decades. Rather than teach them how to enjoy poor health through eating McDonald’s and other fast food in preference to traditional diets, we might export our growing array of cost-effective health maintenance and improvement technologies, already the only way we can solve our own healthcare crisis.